Provider Demographics
NPI:1972610111
Name:ALPHAMED EXPRESS
Entity Type:Organization
Organization Name:ALPHAMED EXPRESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL PARTNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ELLEN
Authorized Official - Middle Name:M
Authorized Official - Last Name:ALLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-791-6322
Mailing Address - Street 1:PO BOX 1696
Mailing Address - Street 2:
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20108-1696
Mailing Address - Country:US
Mailing Address - Phone:703-791-6322
Mailing Address - Fax:
Practice Address - Street 1:14101 WALTON DR
Practice Address - Street 2:
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20112-3702
Practice Address - Country:US
Practice Address - Phone:703-791-6322
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA06L03290332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA262604OtherBC/BS PROVIDER NUMBER
VA1100540001Medicare ID - Type UnspecifiedPROVIDER NUMBER